Body Composition and Muscular Strength in Elite Competitive Athletes and Healthy Controls Aged 65 and Older

Purpose: The purpose of this study is to determine if components of body composition differ between elite competitive older athletes and community-dwelling ambulatory controls and to examine the relationships between the components of body composition and the relationship between the components and strength.Methods: One-hundred Senior Athletes from the 2005 National Senior Games and 86 healthy controls participated. Body composition was measured by dual-energy x-ray absorptiometry (DXA). The DXA scans provided measures of bone mineral density (BMD), bone mass, mineral free lean mass percentage (MFLP), and fat mass percentage (FMP) including regional measures (trunk, legs and arms) of body composition. Isometric strength of the quadriceps and hamstrings was measured. Results: One factor ANOVAs (á=.05) were performed to assess regional FMP and regional MFLP. Controls had a significantly higher FMP in every body region than athletes. Athletes had a significantly higher MFLP of the arm and leg than controls. Correlational analyses (á=.05) were also performed to examine the relationship between MFLP and strength, MFLP and BMD, and FMP and BMD. Athletes had a stronger correlation between flexion strength values and MFLP of the leg and Controls showed a stronger correlation between extension strength values and MFLP of the leg. Significant correlations were found for the relationship between MFLP and BMD, with stronger correlations in the athlete group. Significant correlations between BMD and FMP were found in all regions except the trunk for all groups.Discussion: Our predominant findings were that, as expected, all regional measures of body fat were higher in control subjects than in athletes. This study showed that all regional measures of lean muscle mass were greater in athletes than in control subjects. This indicates that physical activity may help to prevent the decrements associated with the aging process even well in to the 7th decade of life

SYNCHRONIZATION AND TOWING EFFECT ON ADULT ONE-DOG CANICROSS PERFORMANCE

Canicross is competitive team sport in which a human athlete is towed via a canine athlete on an elastic gangline. Although human performance factors play a role in the success of the canicross team, the interaction between human and canine athletes may also play a crucial role on the performance of the team. The purpose of this study was to assess the synchronization patterns across different locations in competitive canicross events and investigate the influences of canine mass on a timed trial event. Video was taken at five locations along the trail of two different competitive canicross events. Synchronization was mapped and a total synchronization score was given to each of the 19 canicross teams. The results of the current study suggest that neither synchronization score nor human to canine mass ratios were correlated with performance

Coping and support-seeking in out-of-home care: A qualitative study of the views of young people in care in England

Objectives Young people who have been removed from their family home and placed in out-of-home care have commonly experienced abuse, neglect and/or other forms of early adversity. High rates of mental health difficulties have been well documented in this group. The aim of this research was to explore the experiences of these young people within the care system, particularly in relation to support-seeking and coping with emotional needs, to better understand feasible and acceptable ways to improve outcomes for these young people. Design and study setting This study used 1:1 semistructured qualitative interviews with young people in out-of-home care in England, to provide an in-depth understanding of their views of coping and support for their emotional needs, both in terms of support networks and experiences with mental health services. Participants were 25 young people aged 10-16 years old (56% female), and included young people living with non-biological foster carers, kinship carers and in residential group homes. Results Participants described positive (eg, feeling safe) and negative (eg, feeling judged) aspects to being in care. Carers were identified as the primary source of support, with a supportive adult central to coping. Views on support and coping differed for young people who were experiencing more significant mental health difficulties, with this group largely reporting feeling unsupported and many engaging in self-harm. The minority of participants had accessed formal mental health support, and opinions on usefulness were mixed. Conclusions Results provide insight, from the perspective of care-experienced young people, about both barriers and facilitators to help-seeking, as well as avenues for improving support

Rim lesions are demonstrated in early relapsing–remitting multiple sclerosis using 3 T-based susceptibility-weighted imaging in a multi-institutional setting

PURPOSE: Rim lesions, characterised by a paramagnetic rim on susceptibility-based MRI, have been suggested to reflect chronic inflammatory demyelination in multiple sclerosis (MS) patients. Here, we assess, through susceptibility-weighted imaging (SWI), the prevalence, longitudinal volume evolution and clinical associations of rim lesions in subjects with early relapsing–remitting MS (RRMS). METHODS: Subjects (n = 44) with recently diagnosed RRMS underwent 3 T MRI at baseline (M0) and 1 year (M12) as part of a multi-centre study. SWI was acquired at M12 using a 3D segmented gradient-echo echo-planar imaging sequence. Rim lesions identified on SWI were manually segmented on FLAIR images at both time points for volumetric analysis. RESULTS: Twelve subjects (27%) had at least one rim lesion at M12. A linear mixed-effects model, with ‘subject’ as a random factor, revealed mixed evidence for the difference in longitudinal volume change between rim lesions and non-rim lesions (p = 0.0350 and p = 0.0556 for subjects with and without rim lesions, respectively). All 25 rim lesions identified showed T1-weighted hypointense signal. Subjects with and without rim lesions did not differ significantly with respect to age, disease duration or clinical measures of disability (p > 0.05). CONCLUSION: We demonstrate that rim lesions are detectable in early-stage RRMS on 3 T MRI across multiple centres, although their relationship to lesion enlargement is equivocal in this small cohort. Identification of SWI rims was subjective. Agreed criteria for defining rim lesions and their further validation as a biomarker of chronic inflammation are required for translation of SWI into routine MS clinical practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00234-021-02768-x

Cracks in the Melting Pot: Immigration, School Choice, and Segregation *

Abstract This paper examines whether the large wave of Mexican immigration to the United States since 1970 has lowered non-Hispanic demand for public education. Our analysis focuses on California, where many of these immigrants settled, accounts for endogeneity of immigrant inflows using established settlement patterns, and uses relative outflows of children from a district to identify shifts in district choice working through schools. We find that between 1970 and 2000, the average metropolitan school district in California lost at least 12 non-Hispanic children to other school districts and two to private school within district for every ten additional low-English Hispanic arrivals in its public schools. These responses are similar in magnitude to "white flight" from school districts court-ordered to desegregate in the 1960s and 1970s

Effect of a pediatric early warning system on all-cause mortality in Hospitalized pediatric patients: The epoch randomized clinical trial

IMPORTANCE: There is limited evidence that the use of severity of illness scores in pediatric patients can facilitate timely admission to the intensive care unit or improve patient outcomes. OBJECTIVE: To determine the effect of the Bedside Paediatric Early Warning System (BedsidePEWS) on all-cause hospital mortality and late admission to the intensive care unit (ICU), cardiac arrest, and ICU resource use. DESIGN, SETTING, AND PARTICIPANTS: A multicenter cluster randomized trial of 21 hospitals located in 7 countries (Belgium, Canada, England, Ireland, Italy, New Zealand, and the Netherlands) that provided inpatient pediatric care for infants (gestational age ≥37 weeks) to teenagers (aged ≤18 years). Participating hospitals had continuous physician staffing and subspecialized pediatric services. Patient enrollment began on February 28, 2011, and ended on June 21, 2015. Follow-up ended on July 19, 2015. INTERVENTIONS: The BedsidePEWS intervention (10 hospitals) was compared with usual care (no severity of illness score; 11 hospitals). MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause hospital mortality. The secondary outcome was a significant clinical deterioration event, which was defined as a composite outcome reflecting late ICU admission. Regression analyses accounted for hospital-level clustering and baseline rates. RESULTS: Among 144539 patient discharges at 21 randomized hospitals, there were 559 443 patient-days and 144539 patients (100%) completed the trial. All-cause hospital mortality was 1.93 per 1000 patient discharges at hospitals with BedsidePEWS and 1.56 per 1000 patient discharges at hospitals with usual care (adjusted between-group rate difference, 0.01 [95% CI, -0.80 to 0.81 per 1000 patient discharges]; adjusted odds ratio, 1.01 [95% CI, 0.61 to 1.69]; P =.96). Significant clinical deterioration events occurred during 0.50 per 1000 patient-days at hospitals with BedsidePEWS vs 0.84 per 1000 patient-days at hospitals with usual care (adjusted between-group rate difference, -0.34 [95% CI, -0.73 to 0.05 per 1000 patient-days]; adjusted rate ratio, 0.77 [95% CI, 0.61 to 0.97]; P =.03). CONCLUSIONS AND RELEVANCE: Implementation of the Bedside Paediatric Early Warning System compared with usual care did not significantly decrease all-cause mortality among hospitalized pediatric patients. These findings do not support the use of this system to reduce mortality

Genome-wide association study identifies a variant in HDAC9 associated with large vessel ischemic stroke

Genetic factors have been implicated in stroke risk but few replicated associations have been reported. We conducted a genome-wide association study (GWAS) in ischemic stroke and its subtypes in 3,548 cases and 5,972 controls, all of European ancestry. Replication of potential signals was performed in 5,859 cases and 6,281 controls. We replicated reported associations between variants close to PITX2 and ZFHX3 with cardioembolic stroke, and a 9p21 locus with large vessel stroke. We identified a novel association for a SNP within the histone deacetylase 9(HDAC9) gene on chromosome 7p21.1 which was associated with large vessel stroke including additional replication in a further 735 cases and 28583 controls (rs11984041, combined P = 1.87×10−11, OR=1.42 (95% CI) 1.28-1.57). All four loci exhibit evidence for heterogeneity of effect across the stroke subtypes, with some, and possibly all, affecting risk for only one subtype. This suggests differing genetic architectures for different stroke subtypes

MRI-derived g-ratio and lesion severity in newly diagnosed multiple sclerosis

Myelin loss is associated with axonal damage in established multiple sclerosis. This relationship is challenging to study in vivo in early disease. Here, we ask whether myelin loss is associated with axonal damage at diagnosis, by combining non-invasive neuroimaging and blood biomarkers. We performed quantitative microstructural MRI and single molecule ELISA plasma neurofilament measurement in 73 patients with newly diagnosed, immunotherapy naïve relapsing-remitting multiple sclerosis. Myelin integrity was evaluated using aggregate g-ratios, derived from magnetization transfer saturation (MTsat) and neurite orientation dispersion and density imaging (NODDI) diffusion data. We found significantly higher g-ratios within cerebral white matter lesions (suggesting myelin loss) compared with normal-appearing white matter (0.61 vs 0.57, difference 0.036, 95% CI 0.029 to 0.043, p < 0.001). Lesion volume (Spearman’s rho rs= 0.38, p < 0.001) and g-ratio (rs= 0.24 p < 0.05) correlated independently with plasma neurofilament. In patients with substantial lesion load (n = 38), those with higher g-ratio (defined as greater than median) were more likely to have abnormally elevated plasma neurofilament than those with normal g-ratio (defined as less than median) (11/23 [48%] versus 2/15 [13%] p < 0.05). These data suggest that, even at multiple sclerosis diagnosis, reduced myelin integrity is associated with axonal damage. MRI-derived g-ratio may provide useful additional information regarding lesion severity, and help to identify individuals with a high degree of axonal damage at disease onset. York, Martin et al. simultaneously measured g-ratio and plasma neurofilament in 73 relapsing-remitting multiple sclerosis patients at diagnosis using advanced MRI and single molecule ELISA. They demonstrate that g-ratio of cerebral white matter lesions varies at diagnosis, and show that high g-ratio of lesions is associated with elevated plasma neurofilament

The Lost Library of Anne Conway

The philosopher Anne Conway (1631-1679) owned a large library, and her reading and book ownership shaped her intellectual life in distinctive ways. Until now, however, almost nothing has been known about the details of her reading or her book collection. Current scholarship assumes that her library, like that of her husband, the third Viscount Conway (c. 1623–1683), was lost or dispersed after her death. This article presents previously unrecognised evidence of Conway’s book ownership, and identifies, for the first time, the only books currently known to survive from her personal library. It traces their path to their current location in the Old Library of Jesus College, Cambridge, through the library of the soldier, book collector, and Cambridge Fellow Francis Sterling (c. 1652-1692). The article demonstrates that the newly identified books reveal previously unknown patterns of intellectual exchange amongst Conway’s family, and argues that they have significant implications for our understanding of her early intellectual development

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy